AB0543 HIGHER LEFT VENTRICULAR MASS INDEX IN PATIENTS WITH LUPUS NEPHRITIS
Authors: N. Guajardo-Jauregui, J. R. Azpiri-López, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado, A. Cárdenas, A. N. Garza-Cisneros, A. Garcia-Heredia, M. A. Balderas-Palacios, A. B. Rodriguez-Romero
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) patients have a worse cardiovascular prognosis than the general population. It is estimated that approximately 40% of SLE patients develop lupus nephritis (LN) throughout the evolution of the disease (1). Patients with LN had 8 times more risk of myocardial infarction and 4 times more risk of cardiovascular mortality than SLE patients without LN (2). Objectives To compare the echocardiographic parameters between SLE patients with and without LN. Methods This was a cross-sectional study nested of a SLE cohort. We recruited patients with SLE diagnosis, according to the 2019 EULAR/ACR classification criteria, aged ≥ 18 years. Patients with a previous cardiovascular event, another connective tissue disease or pregnancy were excluded. A transthoracic echocardiogram was performed by two certified echocardiographers blinded to clinical information. Patients with LN were included and matched to patients without LN by age and gender. Distribution was evaluated with the Kolmogorov-Smirnov test. Comparisons were done with Chi-square test or Fisher’s exact test for qualitative variables, and Student’s T test or Mann-Whitney’s U test for quantitative variables. A p -value &lt; 0.05 was considered statistically significant. Results A total of 48 SLE patients, 24 with LN and 24 without LN were included. Mean age of patients with LN was 36.9 ± 10.4 years, compared to 36.5 ± 9.3 years in patients without LN, p = 0.873. There were no significant differences in demographic characteristics between groups (Figure 1). When evaluating echocardiographic parameters we found a significant difference in the left ventricular mass index, higher in LN patients (66.9 g/m 2 vs 54.8 g/m 2 , p = 0.035) (Table 1). Table 1. Comparison of echocardiographic findings of SLE patients with and without LN. Variables Patients with LN (n=24) Patients without LN (n=24) p -value LV mass index, g/m 2 , mean ± SD 66.9 ± 21.8 54.8 ± 16.1 0.035 RWT, mean ± SD 0.37 ± 0.08 0.34 ± 0.10 NS LV geometry abnormality, n (%) 7 (29.2) 4 (16.7) NS LAESVI, ml/m 2 , mean ± SD 29.72 ± 10.80 26.04 ± 8.76 NS LVEF, %, mean ± SD 58.16 ± 7.42 58.04 ± 7.04 NS LVESV, ml, median (IQR) 39.0 (26.0-54.5) 32.5 (23.7-39.7) NS LVEDV, ml, mean ± SD 92.10 ± 25.09 81.57 ± 27.80 NS SLE, systemic lupus erythematosus; LN, lupus nephritis; NS, not significant; LV, left ventricular; RWT, relative wall thickness; LAESVI, left atrial end-systolic volume index; LVEF, left ventricular ejection fraction; LVESV, left ventricular end-systolic volume; LVEDV, left ventricular end-diastolic volume. Conclusion SLE patients with LN had higher left ventricular mass index than SLE patients without LN. An increased left ventricular mass could lead to the development of ventricular hypertrophy, which is associated to a higher risk of cardiovascular mortality. A transthoracic echocardiogram should be considered as part of the cardiovascular evaluation of SLE patients, especially those with LN. References [1]Hoover PJ, Costenbader KH. Insights into the epidemiology and management of lupus nephritis from the US rheumatologist’s perspective. Kidney Int 2016;90(3):487–92. [2]Hermansen ML, Lindhardsen J, Torp-Pedersen C, et al. The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis: A Danish nationwide population-based cohort study. Rheumatol (United Kingdom) 2017;56(5):709–15. Disclosure of Interests None declared